Counterstories: who counts as lesbian?

Coming out midlife is a profound and life‐changing experience—it is an experience of self‐shattering that entails the destabilisation of identity, and of family relationships. Entailing a displacement from social insider to outsider, it is a difficult, but also exhilarating, journey of self, and sexual, discovery. This thesis is an examination of the experiences of nine women who undertook that journey. This dissertation is very much a search for understanding—for understanding how one can be lesbian, and how one can not have known, following a lifetime of heterosexual identification—as well as a search for why those questions arise in the first place. I argue that the experience of coming out midlife exposes the fundamental ambiguity of sexuality; and has a significance that ranges beyond the particularity of the participants’ experiences and speaks to the limitations of the hegemonic sexual paradigm itself. Using the theoretical lens of three diverse conceptual approaches—the dynamic systems theory of sexual fluidity; liminality; and narrative identity—to illuminate their transition, I argue that the event of coming out midlife should be viewed not merely as an atypical experience, but rather we should ask what such events can tell us about women’s sexuality in particular, and the sexual paradigm more generally. I argue that women who come out midlife challenge those dominant discourses of sexuality that would entail that women who come out midlife were either in denial of their “true” sexuality throughout their adult lives; or that they are not really lesbian now. The experiences of the women I interviewed demonstrate the inadequacy of the sexual paradigm as a framework within which to understand and research the complexity of human sexuality; they also challenge hegemonic understandings of sexuality as innate and immutable. In this thesis, I explore that challenge.

Evaluation of a partnership between primary and secondary care providing an accessible Level 1 sexual health service in the community

Comprehensive testing for asymptomatic sexually transmitted infections in Northern Ireland has traditionally been provided by genitourinary medicine clinics. As patient demand for services has increased while budgets have remained limited, there has been increasing difficulty in accommodating this demand. In May 2013, the newly commissioned specialist Sexual Health service in the South Eastern Trust sought to pilot a new model of care working alongside a GP partnership of 12 practices. A training programme to enable GPs and practice nurses to deliver Level 1 sexual health care to heterosexual patients aged >16 years, in accordance with the standards of BASHH, was developed. A comprehensive care pathway and dedicated community health advisor supported this new model with close liaison between primary and secondary care. Testing for Chlamydia, gonorrhoea, HIV and syphilis was offered. The aims of the pilot were achieved, namely to provide accessible, cost-effective sexual health care within a framework of robust clinical governance. Furthermore, it uncovered a high positivity rate for Chlamydia, especially in young men attending their general practice, and demonstrated a high level of patient satisfaction. Moreover the capacity of secondary care to deliver Levels 2 and 3 services was increased.

A case study of child sexual abuse within a Church community

A case study is presented of child sexual assault within a church community. How does a church community deal with the accusation of an adolescent female that-as a 13-year old-she was sexually victimised and assaulted by her then 18-year old boyfriend, five years her senior? Practical and pastoral issues, as well as ethical and legal concerns are addressed. Consideration is also given to the theological context of the church environments in which the situations arise. The implications for victims, perpetrators, leaders, and the church community of our actions-and failure to take appropriate action-are described, along with recommendations for prevention, and best practice in dealing with the sexual abuse of minors within church communities.

The quality of community reintegration planning for child molesters : effects on sexual recidivism

Research on the causal factors underlying sex offender recidivism has not considered the success or failure of the reintegration process by which the offender rejoins the community after prison. The authors developed a coding protocol to measure the quality and comprehensiveness of reintegration planning for sex offenders. The protocol was retrospectively applied to groups of recidivists and nonrecidivists who were matched on static risk level and follow-up time. The protocol demonstrated adequate reliability. Compared to nonrecidivists, recidivists had significantly lower scores relating to accommodation, employment, and the Good Lives Model secondary goods, as well as lower total reintegration plan scores. ANCOVAs showed that when IQ and level of sexual deviance were controlled for, accommodation (a place to live) was significantly related to sexual recidivism and the Good Lives Model—secondary goods was significantly related to any recidivism. These results suggest that poor reintegration planning may be a risk factor for recidivism.

Measuring community and service provider attitudes to child sexual abuse in remote indigenous communities in Western Australia

This study aimed to evaluate a scale to measure attitudes to child sexual abuse (CSA) in remote Australian Indigenous communities. The scale was developed to gauge attitudes that may be inhibiting the reporting of cases of CSA to police, as well as to evaluate whether interventions that focused on collaborative relationships between community members and police resulted in changes in attitudes. Participants included service providers living outside the community (58%), community members (living within the community; 9%), and service providers who were also community members (33%); 18% of participants identified as Indigenous. Principal components analysis revealed a nonintuitive six-factor solution that did not support the original four concepts. Four intuitive factors emerged from an abridged version of the scale: entrenched issues, personal understanding and knowledge, communication between community and government, and community action. The scale detected significant differences between community status and between Indigenous status groups on some factors.

Sexual abuse, antisocial behaviour and substance use: gender differences in young community adolescents

Objective: To investigate gender-specific relationships between self-reported sexual abuse, antisocial behaviour and substance use in a large community sample of adolescents. Method: A cross-sectional study of students aged, on average, 13 (n = 2596), 14 (n = 2475) and 15 years (n = 2290), from 27 schools in South Australia with a questionnaire including sexual abuse, frequency and severity of substance use, depressive symptomatology (CES-D), family functioning (McMaster Family Assessment Device), and antisocial behaviour (an adapted 22-item Self-Report Delinquency Scale). Logistic regression analyses using HLM V5.05 with a population-average model were conducted. Results: In the model considered, reported sexual abuse is significantly independently associated with antisocial behaviour, controlling for confounding factors of depressive symptomatology and family dysfunction, with increased risks of three- to eightfold for sexually abused boys, and two- to threefold for sexually abused girls, compared to nonabused. Increased risks of extreme substance use in sexually abused girls (age 13) and boys (ages 13-15) are more than fourfold, compared to nonabused. Age differences were not statistically significant. Conclusion: Childhood sexual abuse is a risk factor for the development of antisocial behaviour and substance use in young adolescents. Clinicians should be aware of gender differences.

Sexual abuse and suicidality: gender differences in a large community sample of adolescents

Objective: A cross-sectional study of gender specific relationships between self-reported child sexual abuse and suicidality in a community sample of adolescents. Method: Students aged 14 years on average (N = 2,485) from 27 schools in South Australia completed a questionnaire including items on sexual abuse and suicidality, and measures of depression (Centre for Epidemiological Studies Depression Scale), hopelessness (Beck Hopelessness Scale), and family functioning (McMaster Family Assessment Device General Functioning Subscale). Data analysis included logistic regression. Results: In boys, self-report sexual abuse is strongly and independently associated with suicidal thoughts, plans, threats, deliberate self-injury, and suicide attempts, after controlling for current levels of depression, hopelessness, and family dysfunction. In girls, the relationship between sexual abuse and suicidality is mediated fully by depression, hopelessness, and family dysfunction. Girls who report current high distress about sexual abuse, however, have a threefold increased risk of suicidal thoughts and plans, compared to non-abused girls. Boys who report current high distress about sexual abuse have 10-fold increased risk for suicidal plans and threats, and 15-fold increased risk for suicide attempts, compared to non-abused boys. Fifty-five percent (n = 15) of sexually abused boys attempted suicide versus 29% (n = 17) girls. Conclusions: A history of sexual abuse should alert clinicians, professionals and caters in contact with adolescents, to greatly increased risks of suicidal behavior and attempts in boys, even in the absence of depression and hopelessness. Distress following sexual abuse, along with depression and hopelessness indicate increased risk of suicidal behavior in girls, as well as boys. (C) 2004 Published by Elsevier Ltd.

Multi-victim sexual assault : a case study in rural Australia

Objective: There is a paucity of information regarding cases of multi-victim sexual assault of children. The reported incidence suggests that these cases are rare. The aim of this paper is to provide practitioners with information about effective intervention strategies arising out of the direct experience of managing a case of multi-victim sexual assault in an Australian rural community. --------- Method: A descriptive, case-report methodology summarizing the investigation and intervention in a case of multi-victim sexual assault is reported. A community based intervention arising out of the disclosures of 21 male children is described. The intervention occurred at an individual, group, and community level using a coordinated multi-disciplinary team and natural helping networks. ---------- Results: The coordination of police and welfare services increased the communication flow to victims, their families, and the community. The case also demonstrated the utility in regularly briefing political and bureaucratic authorities as well as local officials about emergent issues. Coordinating political and bureaucratic responses was essential in obtaining ongoing support and sufficient researching to enable the effective delivery of services. ---------- Conclusions: Interventions were focused at an individual, group, and community level using a coordinated multi-disciplinary team and natural helping networks. This provided a choice of services which were sensitive to the case setting. Recommendations are offered for practitioners who are confronted with similar events. While this paper describes an approach for intervening in a case of multi-victim sexual assault, further empirical research is needed to enable service deliverers to efficaciously target interventions which offer choice to victims and their families.

Outrage management in cases of sexual harassment as revealed in judicial decisions

Sexual harassment can be conceptualized as a series of interactions between harassers and targets that either inhibit or increase outrage by third parties. The outrage management model predicts the kinds of actions likely to be used by perpetrators to minimize outrage, predicts the consequences of failing to use these tactics—namely backfire, and recommends countertactics to increase outrage. Using this framework, our archival study examined outrage-management tactics reported as evidence in 23 judicial decisions of sexual harassment cases in Australia. The decisions contained precise, detailed information about the circumstances leading to the claim; the events which transpired in the courtroom, including direct quotations; and the judges' interpretations and findings. We found evidence that harassers minimize outrage by covering up the actions, devaluing the target, reinterpreting the events, using official channels to give an appearance of justice, and intimidating or bribing people involved. Targets can respond using countertactics of exposure, validation, reframing, mobilization of support, and resistance. Although there are limitations to using judicial decisions as a source of information, our study points to the value of studying tactics and the importance to harassers of minimizing outrage from their actions. The findings also highlight that, given the limitations of statutory and organizational protections in reducing the incidence and severity of sexual harassment in the community, individual responses may be effective as part of a multilevel response in reducing the incidence and impact of workplace sexual harassment as a gendered harm.

A trial of the distribution of chlamydia self-collection postal specimen kits from Australian community pharmacies

We explored the feasibility of community pharmacies for the distribution of chlamydia specimen self-collection kits, which featured a transport medium allowing postage of urine specimens in Australia. Eligible clients were requested to complete a code-matched risk-screening questionnaire in the pharmacy, and the derived risk scores were compared to the test results from the corresponding specimen. Four Queensland pharmacies distributed 156 kits, while 44 questionnaires and 18 specimens were received.

Substance-related expectancies among men who have sex with men : development of psychometric tools to predict unprotected sexual activity

Significant research has demonstrated direct and indirect associations between substance use and sexual behaviour. Substance use is related to sexual risk-taking and HIV seroconversion among some substance-using MSM. It remains unclear what factors mediate or underlie this relationship, and which substances are associated with greater harm. Substance-related expectancies are hypothesised as potential mechanisms. A conceptual model based on social-cognitive theory was tested, which explores the role of demographic factors, substance use, substance-related expectancies and novelty-seeking personality characteristics in predicting unprotected anal intercourse (UAI) while under the influence, across four commonly used substance types. Phase 1, a qualitative study (N = 20), explored how MSM perceive the effects of substance use on their thoughts, feelings and behaviours, including sexual behaviours. Information was attained through discussion and interviews, resulting in the establishment of key themes. Results indicated MSM experience a wide range of reinforcing aspects associated with substance use. General and specific effects were evident across substance types, and were associated with sexual behaviour and sexual risk-taking. Phase 2 consisted of developing a comprehensive profile of substance-related expectancies for MSM (SEP-MSM) regarding alcohol, cannabis, amyl nitrite and stimulants that possessed sound psychometric properties and was appropriate for use among this group. A cross-sectional questionnaire with 249 participants recruited through gay community networks was used to validate these measures, and involved online data collection, participants rating expectancy items and subsequent factor analysis. Results indicated expectancies can be reliably assessed, and predicted substance use patterns. Phase 3 examined demographic factors, substance use, substance-related expectancies, and novelty-seeking traits among another community sample of MSM (N = 277) throughout Australia, in predicting UAI while under the influence. Using a cross-sectional design, participants were recruited through gay community networks and completed online questionnaires. The SEP-MSM, and associated substance use, predicted UAI. This research extends social-cognitive theory regarding sexual behaviour, and advances understanding of the role of expectancies associated with substance use and sexual risk-taking. Future applications of the SEP-MSM in health promotion, prevention, clinical interventions and research are likely to contribute to reducing harm associated with substance-using MSM (e.g., HIV transmission).

Naming and claiming workplace sexual harassment in Australia

The persistence of sexual harassment in the workplace and the fact such behaviour remains significantly unreported suggest that legal definitions of sexual harassment may not be well understood. In this paper we explore the naming and claiming of sexual harassment in Australian workplaces, drawing on a unique dataset from a national sexual harassment prevalence survey. We compare a group of individuals who stated they had been sexually harassed according to a legal definition with a group who denied having experienced sexual harassment according to this definition but who went on to report sexually harassing behaviours. The study offers important insights into how workplace sexual harassment comes to be defined and understood in the Australian community, as well as some possible explanations for persistently low rates of formal complaints.

The workplace context of sexual harassment in Australia : policing the gender borders

The paper draws on a three year Australian Research Council funded project entitled Sexual Harassment in Australia: Context Outcomes and Prevention. The research to date suggests there is some slippage between legal definitions and community understandings of what constitutes sexual harassment. Moreover, while sexual harassment is often seen by the community and within organisations as the fault of one aberrant individual, in certain workplace contexts sexual harassment is used to ‘police the gender borders’, that is to exclude women and men who do not conform to the dominant workplace gender norms. This type of sexual harassment is a collective form of behaviour often perpetrated by co-workers in male-dominated workplaces which is designed to humiliate ‘outsiders’ so they appear incompetent and will be forced to leave the organisation. While much previous research that has focused on this type of sexual harassment has taken place in military and policing settings, our emerging findings suggest that it is present in a far broader range of workplace contexts. Prevention of this form of sexual harassment is challenging and goes to the heart of organisational culture and work organisation.

Characteristics of the Internet for Criminal Child Sexual Abuse by Online Groomers

This paper presents a number of characteristics of the Internet that makes it attractive to online groomers. Relevant Internet characteristics include disconnected personal communication, mediating technology, universality, network externalities, distribution channel, time moderator, low‐cost standard, electronic double, electronic double manipulation, information asymmetry, infinite virtual capacity, independence in time and space, cyberspace, and dynamic social network. Potential sex offenders join virtual communities, where they meet other persons who have the same interest. A virtual community provides an online meeting place where people with similar interests can communicate and find useful information. Communication between members may be via email, bulletin boards, online chat, web‐based conferencing or other computer‐based media.